Prevalence and Management of Obesity in U.S. Adults With Type 1 Diabetes
Authors: Michael Fang, Justin B. Echouffo-Tcheugui, Elizabeth Selvin
Journal: Annals of Internal Medicine (2023)

LettersSeptember 2023Prevalence and Management of Obesity in U.S. Adults With Type 1 DiabetesMichael Fang, PhD, MHS, Justin B. Echouffo-Tcheugui, MD, PhD, Elizabeth Selvin, PhD, MPHMichael Fang, PhD, MHSDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandSearch for more papers by this author, Justin B. Echouffo-Tcheugui, MD, PhDDivision of Endocrinology, Diabetes and Metabolism, Johns Hopkins School of Medicine, Baltimore, MarylandSearch for more papers by this author, Elizabeth Selvin, PhD, MPHDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0228 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: Glucagon-like peptide-1 receptor agonists and SGLT2 inhibitors may be important adjunct therapies for weight management in persons with T1DM. Our previous work has shown that approximately 5% of U.S. adults with T1DM receive a GLP-1 receptor agonist, and 3% receive an SGLT2 inhibitor (1). We believe at least 2 barriers may prevent greater uptake.The first barrier is safety. As Dr. Popovic and colleagues note, the use of SGLT2 inhibitors is associated with an increased risk for DKA in persons with T1DM. A consensus statement recommends carefully selecting persons with low risk for DKA, reducing insulin therapy, and ...References1. Wallace AS, Chang AR, Shin JI, et al. Obesity and chronic kidney disease in US adults with type 1 and type 2 diabetes mellitus. J Clin Endocrinol Metab. 2022;107:1247-1256. [PMID: 35080610] doi:10.1210/clinem/dgab927 CrossrefMedlineGoogle Scholar2. Danne T, Garg S, Peters AL, et al. International consensus on risk management of diabetic ketoacidosis in patients with type 1 diabetes treated with sodium-glucose cotransporter (SGLT) inhibitors. Diabetes Care. 2019;42:1147-1154. [PMID: 30728224] doi:10.2337/dc18-2316 CrossrefMedlineGoogle Scholar3. Ahrén B, Hirsch IB, Pieber TR, et al; ADJUNCT TWO Investigators. Efficacy and safety of liraglutide added to capped insulin treatment in subjects with type 1 diabetes: the ADJUNCT TWO randomized trial. Diabetes Care. 2016;39:1693-701. [PMID: 27493132] doi:10.2337/dc16-0690 CrossrefMedlineGoogle Scholar4. Holt RIG, DeVries JH, Hess-Fischl A, et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2021;44:2589-2625. [PMID: 34593612] doi:10.2337/dci21-0043 CrossrefMedlineGoogle Scholar5. Taylor SI. The high cost of diabetes drugs: disparate impact on the most vulnerable patients. Diabetes Care. 2020;43:2330-2332. [PMID: 32958616] doi:10.2337/dci20-0039 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael Fang, PhD, MHS; Justin B. Echouffo-Tcheugui, MD, PhD; Elizabeth Selvin, PhD, MPHAffiliations: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MarylandDivision of Endocrinology, Diabetes and Metabolism, Johns Hopkins School of Medicine, Baltimore, MarylandDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3078. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevalence and Management of Obesity in U.S. Adults With Type 1 Diabetes Michael Fang , Yein Jeon , Justin B. Echouffo-Tcheugui , Elizabeth Selvin Prevalence and Management of Obesity in U.S. Adults With Type 1 Diabetes Djordje Popovic , Dimitrios Patoulias , Nikolaos Papanas Metrics September 2023Volume 176, Issue 9 Keywords Diet Exercise Health surveys Insulin Obesity Overweight Prevention, policy, and public health Type 1 diabetes Type 2 diabetes Weight loss ePublished: 19 September 2023 Issue Published: September 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...